The Doyle Report

State is prepared on two fiscal questions

March 4, 2011

West Virginia is often cited for being dead last or close to it on many lists ranking the states. But our state is way ahead of most of the pack on both unemployment compensation insurance and preparing for the new federalhealth care law.

Over the past three decades two national commissions and several government audits warned states about the decreasing amounts of money they were setting aside to pay unemployment compensation to laid-off workers. Most states ignored the warnings, but West Virginia did not.

As a result, West Virginia is one of only three or four states that have not had to borrow money from the federal government to stabilize their unemployment compensation funds.

Many states got in trouble because they heeded pleas from the business community to lower unemployment compensation premiums. Others significantly increased the weekly benefits to unemployed workers. The result has been a fiscal disaster.

Texas had to borrow $1.3 billion for unemployment compensation in 2009 alone. California has borrowed about $10 billion from the federal government and owes that plus about $360 million in interest. New Jersey has borrowed $1.75 billion.

These are extreme examples. Georgia is more like the norm, having borrowed about $600 million. Michigan became in 2006 the first state to borrow from the federal government to bolster its unemployment compensation trust fund.

Two years ago West Virginia raised its unemployment compensation premiums to businesses. We in the Legislature who supported that move were severely criticized at the time. But most other states will now have to do so to repay the federal government what they borrowed, plus interest. Since we won't have to do so, our premiums will stay where they are while those of most other states soar past ours.

A study released in January by the New England Journal of Medicine showed that West Virginia is better prepared than all but seven other states to provide its newly insured citizens with primary (non-hospital) care.

Some opponents of the new federal health care law predict that many newly insured Americans will be unable to find primary care doctors who will take them as patients. The New England Journal of Medicine's study concludes that might happen in some states, perhaps many, but not in West Virginia.

The other states the study ranks in the "top 10" in terms of readiness for the new health care rules are all far more prosperous than West Virginia. They are Massachusetts, Vermont, Maine, Rhode Island Connecticut, New York,

Delaware Washington and Hawaii. All nine of these states have better-funded health care systems than our state's.

There are two reasons West Virginia is near the top of this list. We have a very large number of community health centers and we have more primary care doctors, nurse practitioners and other health care professionals per capita than most other states.

West Virginia built its first community health center in the 1960s as part of President Lyndon Johnson's "war on poverty." Now there is such a center within driving distance of almost every West Virginian. Many other states will have to build such a network from scratch.

Shortly after I was elected in 1992 the Legislature recognized a dire shortage of primary care physicians. In response we required each of our three medical schools (West Virginia University, Marshall University and the West Virginia Osteopathic School) to send every student to at least one primary care rotation in an underserved area. We required the same of pharmacists, nurses, physician assistants and dentists.

The theory was that some of these providers who would not have gone into underserved areas without the requirement would discover they liked it. The plan clearly worked extremely well.